How Does Public Knowledge, Attitudes, and Behaviors Correlate in Relation to COVID-19? A Community-Based Cross-Sectional Study in Nepal

  1. Hridaya Raj Devkota
  2. Tula Ram Sijali
  3. Ramji Bogati
  4. Andrew Clarke
  5. Pratik Adhikary
  6. Rajendra Karkee

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Abstract

Background: The COVID-19 pandemic has created a global health emergency requiring an effective public health response including citizen's roles in preventing spread and controlling the pandemic. Little is known about public knowledge, beliefs and behaviors in-relation to the pandemic in Nepal. This study aims to assess knowledge, attitude and practices (KAP) toward COVID-19 among the general public and to identify associated factors.

Methods: A cross-sectional survey was conducted between May–June 2020 with a sample of 645, recruited from 26 hospitals across Nepal. We conducted telephone interviews using a semi-structured questionnaire related to KAP regarding COVID-19. T -test and one-way ANOVA was conducted to determine group differences for socio-demographic variables. Linear regression and correlational analysis were performed to identify associated factors and measure strength and direction of relationships.

Results: Overall mean scores for knowledge, attitude and practice were 11.6 (SD 4.5), 2.7 (SD 1.8), and 9.9 (SD 1.93) respectively, but differed by socio-demographic characteristics. Positive but weak linear correlations were observed between knowledge-practice ( r = 0.19, p < 0.01) and attitude-practice ( r = 0.08, p < 0.05). The relationship between knowledge and education was fairly strong ( r = 0.34, p < 0.01). Province, place of residence, ecological area, age, gender and caste/ethnicity were also significantly associated with KAP score of participants.

Conclusion: The study found varying degrees of correlation between Knowledge, Attitude and Practice that may increase as the pandemic evolves in Nepal. Knowledge and level of education had positive associations with attitude and adherence to precautionary measures. The findings suggest a need for targeted community awareness interventions for the most vulnerable populations, men, those with no school education, the elderly and people living in rural areas.

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  1. ScreenIT

    SciScore for 10.1101/2020.07.30.20165266: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Before interviews, verbal informed consent was taken from all participants.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analysis: This study analyzed the data using SPSS (version 23.0 for Windows).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strength and limitation of the study: The study sample of 618 was recruited from 26 health facilities across the country and included population groups from different strata including ecological region, caste ethnicity, and both urban and rural residents; although the proportion of urban participants (79%) was disproportionately higher than the national rate and this sampling bias may affect the generalizability of the findings. The purposive selection of health facilities conducting fever clinics may have resulted the selection bias. Likewise, further bias may have occurred with the exclusion of people under 18 years and individuals with communication difficulties. Furthermore, the absence of visual cues on the phone might have hindered attempts to create an enabling environment for the interviews (23). We also acknowledge the possibility of social desirability bias as the data were self-reported.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.3389/fpubh.2020.589372
  3. Version published to 10.1101/2020.07.30.20165266v1 on medRxiv